Provider Demographics
NPI:1285837310
Name:STERBENZ, WANDA L (RD,LD,OTR,L)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:L
Last Name:STERBENZ
Suffix:
Gender:F
Credentials:RD,LD,OTR,L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7834 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3925
Mailing Address - Country:US
Mailing Address - Phone:913-341-9382
Mailing Address - Fax:
Practice Address - Street 1:400 N 18TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-4208
Practice Address - Country:US
Practice Address - Phone:913-321-8765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004028283133V00000X
KS17-01106225X00000X
MO004332225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist